Sens. Ted Cruz of Texas,
left, and Mike Lee of Utah are among four senators who say they can't support the Senate GOP's health care bill as drafted. (Photo: Michael Reynolds/EPA/Newscom)

Four conservative senators promptly said they can’t support the draft of a health care bill released Thursday by the Senate’s Republican leadership as a cure for Obamacare.

“Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor,” Sens. Rand Paul of Kentucky, Ted Cruz of Texas, Ron Johnson of Wisconsin, and Mike Lee of Utah wrote in a formal statement.

“There are provisions in this draft that represent an improvement to our current health care system, but it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs,” the four senators wrote.

The Senate plan would end mandates for health insurance, including the Obamacare mandate forcing consumers to buy insurance or pay a penalty. It also would phase out the Medicaid expansion under Obamacare over three years, Axios reported.

The eventual support of Cruz, Johnson, Lee, and Paul is crucial because Republicans have a 52-46 majority over Democrats in the Senate. Two independents caucus with the Democrats.

Republicans will need at least 51 votes to pass a health care bill under a procedure known as budget reconciliation, with Vice President Mike Pence empowered to break a tie.

President Donald Trump said Wednesday night in a speech in Cedar Rapids, Iowa, that it would be “so easy and so beautiful” if some Democrats would judge the final plan on its merits.

“It would be a beautiful, beautiful thing if we could get together as two parties that love our country and come up with that great health care and come up with that great tax deal for our people .?.?. and infrastructure, and so many other things,” Trump said.

One major difference in form in the Senate plan compared with the House-passed version of the health care bill is the absence of the so-calledMacArthur amendment.

The MacArthur amendment, negotiated in the House to resolve differences between conservative and centrist Republicans, gives states “the ability to repeal cost-driving aspects of Obamacare” left in place in the original version of the American Health Care Act, the House Freedom Caucus saidin a formal statement.

The Senate proposal instead leans on Obamacare’s “Section 1332 waiver,” described this way by Heritage Foundation health policy expert Robert Moffit in a recent report:

Section 1332 of Obamacare allows states to apply to the secretary of the Department of Health and Human Services (HHS) and get a ‘waiver’ from 11 statutory provisions, including the individual and employer mandates, the actuarial value mandate that determines coverage levels, the federal rules governing the definition of individual and small group coverage, and the federal essential health benefit requirements.

How much flexibility states will have under the Section 1332 waiver is an important question, some observers say.

In a statement provided to The Daily Signal, Moffit, who was traveling, said he is not sure how the Senate’s proposed legislation would repeal and replace Obamacare.

Overall, the Senate bill is better than Obamacare because it contains provisions to reduce insurance premiums and promote access to insurance in the short run; cut taxes; and provide major Medicaid reform that will help refocus the program to those most in need.

It is still an open question, however, whether the bill will repair enough of the damage caused by Obamacare so that the middle-class self-employed will be able to find affordable health insurance in five years.

The Senate plan retains Obamacare’s requirements for covering pre-existing conditions and preserves Obamacare’s tax credits for individuals based on age, location, income and geography, The Hill reported.

The legislation also would retain for two years Obamacare’s cost-sharing subsidies, which were created to reduce out-of-pocket costs for low-income patients who purchase silver-level insurance plans through Obamacare’s exchanges, as The Daily Signal previously reported.

Senate Democrats, some of whom Trump appears to be trying to shame publicly into negotiating, are wary of the draft. Minority Leader Chuck Schumer, D-N.Y., was among them, tweeting:

Senate Republicans’ draft also specifies that tax credits could not be used to pay for abortions.

Rep. Andy Biggs, R-Ariz., a member of the House Freedom Caucus, voiced concern in a statement about the Senate draft:

I am extremely disappointed by the lack of resolve from Congress to repeal Obamacare—most recently, with the U.S. Senate’s legislation. The American people demanded a full repeal. Now, the 115thCongress is dangerously close to abandoning our promise and opportunity to completely repeal Obamacare, remove government from the health care industry, permanently defund Planned Parenthood, and give Americans their long-awaited relief from overwhelming premiums.

Sen. James Lankford, R-Okla., another conservative senator, said he is studying the draft and hasn’t made up his mind.

“I’m going through it,” Lankford said in an interview with CNN. “I have a lot of questions still, a lot of things we have talked about. It’s 142 pages of text, but there’s things piled into that text that we’ve got to decipher. Put me down as a solid undecided.”

Ken McIntyre contributed to this report.

The Daily Signal depends on the support of readers like you. Donate now

Rachel del Guidice is a reporter for The Daily Signal. She is a graduate of Franciscan University of Steubenville, Forge Leadership Network, and The Heritage Foundation’s Young Leaders Program. Send an email to Rachel.

Don’t have time to read the Washington Post or New York Times? Then get The Morning Bell, an early morning edition of the day’s most important political news, conservative commentary and original reporting from a team committed to following the truth no matter where it leads.

Email address

Ever feel like the only difference between the New York Times and Washington Post is the name? We do. Try the Morning Bell and get the day’s most important news and commentary from a team committed to the truth in formats that respect your time…and your intelligence.